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Background: Prediabetes is a condition preceding the development of diabetes and is associated with an increased risk of a number of complications. The primary mode of management is thought to be lifestyle modification. Pharmacological therapy, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs), were not well addressed in the literature and were only evaluated in trials as secondary and exploratory outcomes with a limited sample size. Here, GLP-1RAs are evaluated as a comprehensive therapy approach for patients with prediabetes. Methods: A comprehensive search of Web of Science, SCOPUS, PubMed, and Cochrane was performed on May 5, 2023, to retrieve randomized controlled trials (RCTs) comparing the effect of GLP-1RAs to placebo and/or lifestyle modification on prediabetes reversion to normoglycemia, prevention of overt diabetes, glycemic control, anthropometric parameters, and lipid profiles. Review Manager (RevMan) version 5.4 was used. The quality of RCTs was assessed using the revised version of the Cochrane Risk of Bias Tool. GRADE was performed to evaluate the certainty of evidence. Results: Twelve trials involving 2903 patients in the GLP-1RAs group and 1413 in the control group were included in the meta-analysis. Low quality of evidence revealed that GLP-1RAs significantly increased the incidence of prediabetes reversion to the normoglycemic state [RR = 1.76, 95% CI (1.45, 2.13), P < 0.00001] and moderate quality of evidence showed that GLP-1RAs significantly prevented new-onset diabetes [RR = 0.28, 95% CI (0.19, 0.43), P < 0.00001]. Significant reductions in HbA1c, fasting plasma glucose, body weight, waist circumference, triglycerides, and LDL were observed in the GLP-1RAs arm (P < 0.05). However, higher incidences of gastrointestinal disorders were reported in the GLP-1RAs group (P < 0.05). Conclusions: GLP-1RAs combined with lifestyle modification proved to be a more effective therapy for managing prediabetic patients than lifestyle modification alone, with a tolerable safety profile. Future guidelines should consider GLP-1RAs as an adjunct to lifestyle modification in the management of prediabetic patients to provide better management and improve treatment adherence. [ABSTRACT FROM AUTHOR]

The motivations of disabled individuals to become entrepreneurs can be influenced by various factors. Throughout their careers and projects, entrepreneurs with disabilities may face multiple personal, social, and political obstacles. This research aims to develop a rigorous, systematic examination of the literature on the obstacles disabled people must overcome to become entrepreneurs. The literature review focused on analyzing ten articles from Web of Science and Scopus. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is used to organize the field of research. This compilation of peer-reviewed research papers is necessary for academia and government to realize the vision of shared prosperity by 2030.

OBJECTIVE: Atopic dermatitis (AD) is an inflammatory skin condition affecting both mental and physical health. Although research has shown reduced physical activity levels among patients with AD, there is a scarcity of studies examining baseline mobility, which refers to the standard level of functional ambulation or movement capability. We analyzed the relationship between AD and baseline mobility among U.S. adults ages 20 to 59, utilizing the National Health and Nutrition Examination Survey (NHANES). METHODS: We merged three, 2-year cycles of NHANEs data (2001-2006). Patients were categorized as having "impaired mobility" by the following question: "Because of a health problem, do you have difficulty walking without using any special equipment?" Multivariable logistic regression analyses were performed using STATA/SE 18.0. RESULTS: Our analysis included 6,540 participants. The prevalence of impaired mobility was 7.1 percent among patients with AD and 3.9 percent among those without AD. This difference was statistically significant among patients aged 20 to 59 after adjusting for potential confounding variables (adjusted odds ratio [AOR], 1.65; 95% CI, 1.19-3.25; P=0.010). Subgroup analysis showed increased rates of impaired mobility among males with AD (AOR, 2.55; 95% CI, 1.21-5.40; P=0.016), and among adults aged 40 to 59 (AOR, 1.94; 95% CI, 1.03-3.68; P=0.042). LIMITATIONS: Limitations to our study include lack of specificity in the survey questionnaire, self-reporting bias, and an age limit of 59 years old. CONCLUSION: Our study demonstrated a statistically significant elevation in impaired mobility among individuals with AD compared to those without AD. This underscores the importance of comprehensive care for AD patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: The maintenance of oral hygiene and subsequent health related issues in visually handicapped children is a challenging task. Hence, tools must be used to ensure good oral health in these children. The study aimed to analyze the effectiveness of preventive programs on oral health using specialized audio and tactile aids in visually impaired school children. MATERIALS AND METHODS: 100 visually handicapped children were selected for the study. They were divided into two groups: Group A (Training using Braille) and Group B (training by means of audio aids). Children were trained using appropriate tools and oral health was assessed using Plaque and Gingival bleeding indices. STATISTICAL ANALYSIS: Independent ‘T-test’ was used for comparing mean ± SD values. RESULTS: Statistically significant improvements in both plaque and gingival bleeding indices were obtained on follow-up observations at 3rd and 6th months. CONCLUSION: The use of specialized tactile and audio tools significantly improved the oral health status of visually impaired school children.

Histone deacetylase-8 (HDAC8) is a unique member of class I Zn2+-dependent metalloenzyme of the classical histone deacetylases owing to its highly structural and kinetic characterization. Of interest, the diminution in the expression level of HDAC8 and or the impaired activity of the enzyme has been correlated with various pathophysiological events, such as neuroblastoma cancer, chronic obstructive pulmonary disease (COPD), Cornelia de Lange syndrome (CdLs) and other metabolic dysfunction. Notwithstanding, HDAC8 has been considered a high priority drug target, and because of the therapeutic benefits associated with HDAC8 inhibitors, the majority of the current research is geared toward searching for inhibitors of this enzyme. In addition, the potential for treating metabolic and age-related diseases by activation is gradually gaining attention. However, currently only a few researchers have reported on the biochemical significance of activators of HDAC8 and the information gathered further indicates that the combination of both activators and inhibitors could be a promising therapeutic strategy toward dissecting the role of HDAC8 in associated diseases. Therefore, the primary aim of this review is to elaborate on the prospects of combining HDAC8 activators and inhibitors for disease treatments due to HDAC8 diminution or impaired activity.

Para taekwondo is a combat sport martial art that requires fast reaction times for successful defense during fighting. The current classification system is based on the function and the effective length of the upper limbs, which affects the athlete's ability to block. Therefore, this study aimed to investigate the differences between the different classes in the athlete's ability to block and move around the ring. A total of 87 Para taekwondo (K42, K43, and K44) athletes' data were analyzed. Each participant engaged in the blocking reaction time test in a fighting stance with the left leg in front, the right leg in front, and the legs parallel in random order. A foot-stepping reaction test was performed to anlyze how the athletes moved in various directions. The results indicated no significant differences between the classes for the lower body foot stepping reaction times and the upper body blocking performance times. The stimulated blocking time of the Para taekwondo athletes ranged from 0.79 to 0.97 s Furthermore, the neurological group (0.86 ± 0.09 s) was significantly slower than the amputation/dysmelia group (0.81 ± 0.07 s). We thus concluded that the neurologically impaired athletes were disadvantaged and therefore belonged in a separate class. [ABSTRACT FROM AUTHOR]

Abstract Background Physical and functional losses due to aging and diseases decrease human mobility, independence, and quality of life. This study is aimed at summarizing and quantifying these losses in order to motivate solutions to overcome them with a special focus on the possibilities by using lower limb exoskeletons. Methods A narrative literature review was performed to determine a broad range of mobility-related physical and functional measures that are affected by aging and selected cardiovascular, respiratory, musculoskeletal, and neurological diseases. Results The study identified that decreases in limb maximum muscle force and power (33% and 49%, respectively, 25–75 yrs) and in maximum oxygen consumption (40%, 20–80 yrs) occur for older adults compared to young adults. Reaction times more than double (18–90 yrs) and losses in the visual, vestibular, and somatosensory systems were reported. Additionally, we found decreases in steps per day (75%, 60–85 yrs), maximum walking speed (24% 25–75 yrs), and maximum six-minute and self-selected walking speed (38% and 21%, respectively, 20–85 yrs), while we found increases in the number of falls relative to the number of steps per day (800%), injuries due to falls (472%, 30–90 yrs) and deaths caused by fall (4000%, 65–90 yrs). Measures were identified to be worse for individuals with impaired mobility. Additional detrimental effects identified for them were the loss of upright standing and locomotion, freezing in movement, joint stress, pain, and changes in gait patterns. Discussion This review shows that aging and chronic conditions result in wide-ranging losses in physical and sensory capabilities. While the impact of these losses are relatively modest for level walking, they become limiting during more demanding tasks such as walking on inclined ground, climbing stairs, or walking over longer periods, and especially when coupled with a debilitating disease. As the physical and functional parameters are closely related, we believe that lost functional capabilities can be indirectly improved by training of the physical capabilities. However, assistive devices can supplement the lost functional capabilities directly by compensating for losses with propulsion, weight support, and balance support. Conclusions Exoskeletons are a new generation of assistive devices that have the potential to provide both, training capabilities and functional compensation, to enhance human mobility.

Background: The maintenance of oral hygiene and subsequent health related issues in visually handicapped children is a challenging task. Hence, tools must be used to ensure good oral health in these children. The study aimed to analyze the effectiveness of preventive programs on oral health using specialized audio and tactile aids in visually impaired school children., Materials and Methods: 100 visually handicapped children were selected for the study. They were divided into two groups: Group A (Training using Braille) and Group B (training by means of audio aids). Children were trained using appropriate tools and oral health was assessed using Plaque and Gingival bleeding indices., Statistical Analysis: Independent 'T-test' was used for comparing mean ± SD values., Results: Statistically significant improvements in both plaque and gingival bleeding indices were obtained on follow-up observations at 3 rd and 6 th months., Conclusion: The use of specialized tactile and audio tools significantly improved the oral health status of visually impaired school children., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Purpose: to develop information technology for technical and tactical training of skilled basketball players with hearing impairments. Material : the study involved 24 women's national team athletes Ukrainian Basketball hearing impaired (age - 25-30 years). Technical protocols were processed 12 games from the World Cup and Europe, XXII Summer Deaflympics. Fixed number of shots and hit free throws, steals, rebounds and on its offensive rebounds, fouls and errors. Results : the developed system of tactical training basketball players with hearing impairments. Accentuation was made of the prevalence of method visibility while developing tactical interactions. The main result was the development of the author's method of video tutorials with animated illustrations. Also, use the lamp LS Line-3-65-12-C to control the training process athletes. Conclusions : there was a significant improvement in competitive activity athletes. Athletes performed significantly more hits from the foul line and successful shots from long range compared to main rivals. Also increased the number of interceptions in games. Application of information technology had an impact on the competitive result: basketball team of Ukraine took the second place in the Deaflympics in Sofia in 2013.

In this exploratory study, the authors surveyed clinical supervisors (n = 138) regarding their knowledge of their supervisees' problems of professional competency (PPC). Findings suggest the majority have observed a supervisee with PPC working towards licensure. Further, those that have supervised a supervisee with PPC have been negatively impacted by these interactions (e.g., increased their workload, increased their stress). [ABSTRACT FROM AUTHOR]

The main goal of early detection of hearing impairment in children is early intervention. There is growing interest in early detection of hearing impairment in developing countries. The main purpose of this study was to investigate the spoken language development in severe to profound hearing impaired children and compared their speech intelligibility with normal hearing children at the same age. Nine severe to profound hearing impaired children below 2 years old out of the primer 42 cases were selected for this survey. They receive aural habilitation and also speech therapy after beginning the speech production. Speech intelligibility test of these children was recorded on audio-tape, when they read five questions which can be answered with one word only, at the age of 4, 5 and 6 in comparison with 27 normal hearing children at the same age. At the age of 4 the mean speech intelligibility score of the studied group was 31.77% (SD 12.17) and the control was %96 (SD 2.23). At the age of 5, this score was %51.22 (SD 14.42), the control one 97.85% (SD 1.93). Finally at age 6 it was 72% (SD 18.97) for hearing–impaired group and 99.22% (SD 1.18) in control one. Severe to profound hearing impaired children acquired spoken language but not at the same level. In general, their speech development showed about 2 to 3 years delay. Their speech intelligibility was acceptable for severe group around the age 6 but almost semi–intelligible for profound group at the same age.

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Abstract: Aims: When non-alcohol drugs are detected in blood samples from apprehended drivers in Norway, individualised expert opinions are required to evaluate degree of impairment. For alcohol, legislative limits have been in use since 1936. To harmonize the current practice for driving under the influence of alcohol and non-alcohol drugs, a judicial reform with legislative limits for non-alcohol drugs has been suggested. Methods: Impairment limits, representing drug concentrations in blood likely to be accompanied by a degree of impairment comparable to a blood alcohol concentration (BAC) of 0.02%, were proposed for 20 psychotropic drugs, including the most prevalent benzodiazepines, cannabis, GHB, hallucinogens and opioids. Limits for graded sanctions, representing drug concentrations in blood likely to induce impairment comparable to BACs of 0.05% and 0.12%, were defined for 13 of the 20 substances. The suggested limits were based on assessments of impairment after single doses of the drugs in naïve individuals. The proposed limits will not apply to individuals with valid prescriptions for medicinal drugs, where the present system with individualised expert evaluations will be maintained. Conclusion: Norway is the first country planning to implement legislative limits for non-alcohol drugs corresponding to impairment seen at increasing BACs. The background and justification for the suggested limits are presented herein. [Copyright &y& Elsevier]

Driving is a classic example of visually guided behavior in which the eyes move before some other action. When approaching a bend in the road, a driver looks across to the inside of the curve before turning the steering wheel. Eye and steering movements are tightly linked, with the eyes leading, which allows the parts of the brain that move the eyes to assist the parts of the brain that control the hands on the wheel. We show here that this optimal relationship deteriorates with levels of breath alcohol well within the current UK legal limit for driving. The eyes move later, and coordination reduces. These changes lead to bad performance and can be detected by an automated in-car system, which warns the driver is no longer fit to drive.Neuropsychopharmacology (2008) 33, 849–858; doi:10.1038/sj.npp.1301458; published online 16 May 2007 [ABSTRACT FROM AUTHOR]

Purpose: Safety data on commonly used herbal medicinal (HM) products (HMPs) and marketed in Ghana are scarce. We assessed the sub-chronic toxicity of three most-patronised commercial antimalarial HMPs in Kumasi, Ghana., Method: Top three HMPs (designated as herbal products 'A' (HPA), 'B' (HPB) and 'C' (HPC)) were selected after a mini-survey and sub-chronic toxicity evaluation conducted in accordance with Organisation for Economic Co-operation and Development (OECD) 407 guidelines. Control rats received clean water while test groups received daily adult human dose (DAHD), 5× DAHD or 10× DAHD of either HPA, HPB or HPC for 30 days. Rats were killed on day 31 to obtain biochemical, haematology and histology samples for analysis. Data were analysed by one-way analysis of variance (ANOVA) and post hoc Tukey's test., Results: The three HMPs produced alterations in liver morphology predominantly characterised by prominent foci of fatty change with scattered hepatocytes containing intracytoplasmic fat globules and congested central veins and sinusoids. The lungs showed alveolar with evidence of inflammation and foci of epithelial sloughing. Alveolar spaces were also obscured by debris and inflammatory cells. HPA and HPC produced scattered intensely congested heart vessels while HPB(10) produced haemorrhage and amorphous exudates within the heart. All HMPs produced neither treatment-related deaths nor significant change in haematological and biochemical parameters, except for HPA and HPB which decreased (P<0.05) aspartate aminotransferase (AST) and HPB, which elevated (P<0.05) fasting blood glucose (FBG)., Conclusion: Data from the present study suggest the potential of the herbal products (HPs), HPA, HPB and HPC, to cause major organ-system dysfunction or damage. We advise cautious use of these products and recommend further safety evaluation in chronic toxicity models., (© 2020 The Author(s).)

Background Treatment results of small molecule tyrosine kinase inhibitors (TKIs) have been improved, but cancer treatment-related cardiac dysfunction (CTRCD) has become a problem. However, the CTRCD risk of TKIs has not been fully clarified, and monitoring indicators have not been established. Therefore, in order to detect CTRCD early, we aimed to pinpoint the TKIs that needs attention. Method Data from the Japanese Adverse Drug Event Report database from April 2004 through January 2018 was used. In this study, a total of 25 TKIs in monotherapy were studied in principle to avoid the presence of concomitant medication. We examined the relationship between heart failure and TKIs with a reporting odds ratio (ROR) which is a signal detection by data mining Method. The 95% confidence interval lower limit value > 1 was taken as a signal. We also confirmed the target kinase and heart failure alert in the package insert of the TKIs. Result Signals of heart failure were detected in 10 (Alectinib, Axitinib, Bosutinib, Dasatinib, Imatinib, Osimertinib, Pazopanib, Ponatinib, Ruxolitinib and Sunitinib) of the 25 TKIs, and ABL-1, VEGFR and PDGFR were common in the target kinases. Signals were also detected in Alectinib, Bosutinib and Osimertinib, but their package inserts did not alert for heart failure. Death cases were also included in reported heart failure cases. Conclusion Knowledge of the ten TKIs or drugs having ABL-1, VEGFR, PDGFR as the target kinase that signal for a risk of heart failure may lead to the early detection of adverse events by monitoring. There are also serious cases for three drugs for which the risk of heart failure is unknown, so we suggest that it is necessary to conduct periodic monitoring. [ABSTRACT FROM AUTHOR]

Background In the treatment of advanced cancer patients with severe cardiac dysfunction, there is a risk that the side effects of the chemotherapy may lead to a serious situation, and it is necessary to carefully judge the indications. There were only a few reported cases of chemotherapy for such patients. Here we report our experience with a patient who had continued chemotherapy for more than a year and a half for advanced sigmoid colon cancer with severe cardiac dysfunction. Case presentation A 73-year-old man came to our hospital because positive fecal occult blood was pointed out in a medical examination in March 2017. He had been diagnosed dilated cardiomyopathy at the age of sixty, and his LVEF was about 25% by the recent echocardiogram. A colonoscopy was performed in May, sigmoid colon cancer was found, and further CT examination was revealed multiple liver metastases. We determined that surgery was not a possible treatment option for him, and we decided to perform chemotherapy. In June we introduced to the patient S-1 plus oxaliplatin combination therapy. We changed to S-1 plus irinotecan combination therapy because of becoming PD from November in the same year. After that SD was maintained for a while, but it became PD by December 2018, and we changed to FTD/TPI as the third line chemotherapy from January 2019. Discussion Median survival of BSC follow-up for unresectable advanced recurrent colorectal cancer was reported to be 6 to 8 months. This case has survived more than a year and a half after starting chemotherapy, suggesting that chemotherapy should be performed as much as possible even for cancer patients with severe cardiac dysfunction. However, there are few such case reports, and it is necessary to accumulate and study more cases from now on. [ABSTRACT FROM AUTHOR]

Background One year of adjuvant trastuzumab in combination with chemotherapy is the standard of care in early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Existing data on shortening trastuzumab treatment show conflicting results. Methods A search of PubMed and abstracts from key conferences identified randomized trials that compared abbreviated trastuzumab therapy to 1 year of treatment in early-stage HER2-positive breast cancer. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted for disease-free survival (DFS) and overall survival (OS). Subgroup analyses evaluated the effect of nodal involvement, estrogen receptor expression, and the duration of abbreviated trastuzumab (9–12 weeks vs 6 months). Odds ratios (ORs) and 95% confidence intervals were computed for prespecified cardiotoxicity events including cardiac dysfunction and congestive heart failure. P values were two-sided. Results Analysis included six trials comprising 11 603 patients. Shorter trastuzumab treatment was associated with worse DFS (HR = 1.14, 95% CI = 1.05 to 1.25, P  = .002) and OS (HR = 1.15, 95% CI = 1.02 to 1.29. P  = .02). The effect on DFS was not influenced by estrogen receptor status (P for the subgroup difference = .23), nodal involvement (P  = .44), or the different duration of trastuzumab in the experimental arm (P  = .09). Shorter trastuzumab treatment was associated with lower odds of cardiac dysfunction (OR = 0.67, 95% CI = 0.55 to 0.81, P  < .001) and congestive heart failure (OR = 0.66, 95% CI = 0.50 to 0.86, P  = .003). Conclusions Compared with 1 year, shorter duration of adjuvant trastuzumab is associated with statistically significantly worse DFS and OS despite favorable cardiotoxicity profile. One year of targeted HER2 treatment should remain the standard adjuvant treatment in early-stage HER2-positive disease with appropriate cardiac monitoring. [ABSTRACT FROM AUTHOR]